Endings

Just home from a three-day conference in San Antonio, I was upstairs in the midst of unpacking, opening the mail and returning a phone call when my wife approached me with the news that Avery was in the hospital.

Avery’s wife had called that morning to report that his breathing had gotten much worse while I was away. Repeat x-rays and CT scan showed that the tumors and lymph nodes had enlarged considerably; they were now putting pressure on the breathing tubes in Avery’s lungs. He had developed fluid in the chest, and one lung had partially collapsed.

The fact that I had just facilitated a conference workshop on breaking bad news did not make this latest news any easier to take.

I sifted through the papers on my desk to find the telephone number. The hospital operator patched me through to the critical care unit.

Heavy doses of opiates had paralyzed Avery’s bowels. When he strained at stool earlier that morning, he developed sudden chest pains. His blood pressure shot up to 240/180. Another chest x-ray showed a completely collapsed right lung. Avery was struggling now for each breath.

I told Avery’s wife that I would leave immediately for the hospital.

I found her sitting by the bed, holding Avery’s hand. “Come in,” she said.

Avery lay on his back with his head elevated. The pale green transparent mask covering his nose and mouth fogged with each exhalation. I could see him struggle for every breath. I walked to the opposite side of the bed and stood by the rail.

“You’ve got a visitor,” Avery’s wife said.

Avery opened his eyes and looked at me. “Hey,” he gasped. It was as much as he could muster at the moment.

“You don’t have to make polite conversation,” I said. “I was out for a drive and thought I’d stop in to see how you’re doing.”

Avery flashed a short smile. “Not so good,” he whispered.

“Believe it or not, he’s a bit better than he was this morning,” Avery’s wife said. “They seem to have gotten his pain under control.”

I looked at the IV pump and glanced at the label on the bag of fluid: an infusion of Dilaudid, 5 mg per hour—equivalent to 25 mg of morphine. The massive dose of opiates that relieved Avery’s pain was also suppressing his respiratory drive: a classic Catch-22 situation.

Above Avery’s head a monitor displayed graphs of his heart rate, EKG pattern, respiratory rate and oxygen saturation. Even with the re-breathing bag in place, Avery’s oxygen saturation was only 85 percent.

“Next month would have been our 41st wedding anniversary,” Avery’s wife said. “The way things look, I’ll probably be celebrating it by myself.”

I started to talk, modulating my words and the volume of my voice. Standing on the left side of the bed by his good ear, I told Avery about my recent trip to San Antonio, about the Alamo with its gardens of exotic plants and ancient live oaks, about the Menger Hotel where I stayed, which houses the bar where in 1898 Teddy Roosevelt recruited a number of his band of Rough Riders. Avery flashed his eyes when I talked, acknowledging that he heard what I said.

During my monthly visits over the course of the past year, Avery had done most of the talking. I had been most happy to listen.

Now that Avery was breathless, I found our roles reversed: I was cast as the orator. It wasn’t a role that I was entirely comfortable with. I wanted to give Avery the chance to tell me all those things that he might have wanted or needed to say. Now, because of his physical limitations, he wasn’t able to speak. Feelings of anger began to well up within me, stemming from this injustice that fate had dealt him.

Then I realized something: Avery had spent the last year telling me those things that were important to him. Like a clever old sage, he had drawn me into his web of stories. Little by little, visit after visit, Avery told me everything that he valued: the wonder of life itself—reproducing, nurturing, growing, reaching out, consoling. He spoke about his love for the natural world, the beauty of it, the desire to treat it with respect, even when parts of it had to be sacrificed. He talked about simple pleasures—baking fresh bread or cinnamon rolls, hearing his granddaughter laugh, potting his perennial plants, enjoying a fine cigar or a walk in the woods with his dogs. His extended family, with their quirks and idiosyncrasies and eccentricities, was most important to him. Everything he had told me—all of this—is what he valued. I felt honored to have heard it.

I stayed for a while, then decided to head out. I gave Avery’s wife my cell phone number and asked her to call me with any news.

A thunderstorm broke shortly after I arrived home. I sat on the front porch and watched flashes of lightening shoot across the smoky yellow sky. I turned my shirt collar up against the cold wind. Rain fell in sheets; rivulets formed in the street.

Afterwards, the evening sunlight blazed beneath the parting clouds, turning the fresh spring leaves lemon-green on the hillside. In anticipation I looked up, and there it was: an arc of brilliant colors crowning the dome of sky. Above it, more dimly, a second rainbow glowed.

Out in the yard the violet irises rested atop their long stems. Red impatiens filled the flowerbeds. I noticed the stalks of tiny pale blue flowers scattered throughout the front lawn: telltale forget-me-nots.

Once, during one of our long afternoon conversations, I asked Avery why owls don’t make a sound when they fly. He told me it had something to do with the design of their wings—the primary wing feathers have comb-like fringes that deaden the sound of air as it passes over them during flight.

In the forest I’ve seen owls perch in their roost trees. I’ve strained to listen to their wing beats as they glide down through the forest out of sight. A few silent wing beats, and they are gone.

The following morning they moved Avery to the hospice unit, where his family could rest more comfortably. There, Avery was surrounded by those he loved most. Everyone had a chance to say goodbye.

One never knows about these things, of course—not the minute, not the hour. But when at last the final moment arrived, like an owl in the forest, Avery momentarily spread his wings, dropping down from the branch on which he had been precariously perched, and glided out silently through the trees.

A few soundless beats, and he was gone.

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